Djokovic’s CVAC Conundrum: A Controversial Training Method Examined

13 October, 2011

World No. 1 Novak Djokovic ignited intrigue before the 2011 US Open when he admitted to using an altitude training device made by a company called CVAC (Cyclical Variations in Adaptive Conditioning) Systems.

Djokovic’s Contradiction.

The Wall Street Journalreported that Djokovic began regularly using the egg-shaped device around the time he lost to Rafael Nadal in the 2010 US Open final.

“I think it really helps – not with muscle but more with recovery after an exhausting set,” Djokovic said in August of 2011. “It’s like a spaceship. It’s very interesting technology.”

Allen Ruszkowski, CEO of CVAC Systems, describes the technology’s results as “double what is seen with doping.”

But shortly after the Wall Street Journal story came out, Djokovic denied that he had used the device regularly.

“I have used it a couple of times last year, and I haven’t used it since.” Djokovic said. “It would be great if that machine had wings so it can fly wherever I am playing. I haven’t used it this year because I’m really not intending to change my own routines. I have my own therapist I have with my team and it’s been working well, so I have no reason to really try other things.”

The Wall Street Journal’s piece, however, quoted a coach from the New Jersey facility where the machine is kept, Geoff Grant, who said that Djokovic was planning on using the machine that day, while preparing for the 2011 US Open.

Djokovic’s Ascension.

In 2010, Djokovic was ranked No. 2 and No. 3 at various points in of the season. High ranking aside, Djokovic hadn’t won a single match against a top 10 player the entire year going into the US Open.

The one-time Grand Slam champion Djokovic held a reputation on the ATP Tour of retiring frequently, particularly in big matches, often appearing to struggle with fitness and breathing. His retirements drew criticism from fellow players including 16-time Grand Slam champion Roger Federer.

“I’m almost in favor of saying, you know what, if you’re not fit enough, just get out of here,” Federer said after Djokovic’s 2009 Australian Open retirement.

Djokovic was well on his way to completing a Career Slam of retirements, having retired in each of the Slams, with the exception of the US Open.

But after the 2010 US Open, when he reportedly began to use the CVAC technology, Djokovic went 25-5 on the rest of the year, earning three wins against top 10 players. In 2011, he is 64-3, including a 20-2 record against top 10 players.

In 2011, Novak Djokovic seemingly overnight gained the ability to win 96% of his matches, an enormous difference from the respectable 78% win percentage he accumulated in 2010.

CVAC Explained.

As the body is tested to its limits, the endurance athlete’s muscles hunger for oxygen, which is carried from the lungs to the muscles by red blood cells.

The more red blood cells available to deliver that oxygen, the higher an athlete’s aerobic capacity becomes, which leads to increased endurance and reduced physical effects of fatigue.

For decades, professional athletes have pursued ways to increase the amount of red blood cells in their bodies, both through methods considered acceptable, and through methods that are banned, including blood doping.

Using a hypobaric chamber that simulates a high altitude is a common training method for athletes. Spending time in these chambers simulates the benefit an athlete might get from living at a high altitude and training at a lower altitude, a proven way to improve endurance. The higher altitude forces the body to produce more red blood cells.

But the CVAC chamber is different from traditional altitude training chambers.

The CVAC chamber, instead of simply simulating a higher altitude, cycles through different altitudes. This has shown to maximize the benefits of altitude training, appearing to provide benefits that not only outweigh traditional altitude training, but also require significant less time spent in the chamber to obtain those benefits.

Indeed, a study conducted at the University of Hawaii showed convincing evidence of increased arterial oxygen saturation in athletes using CVAC for just a few hours per week, as opposed to the many hours traditional altitude training requires to see tangible benefits.

And because of this difference between CVAC and other altitude devices, CVAC walks a fine ethical line.

WADA Controversy.

The World Anti-Doping Agency classifies altitude training in hypoxic chambers as violating the “spirit of sport,” although they are not banned.

The WADA code contains three criteria for determining whether to ban a training method: ability of the method to enhance performance, whether the method creates a health risk for the athlete, and whether the method violates the “spirit of sport.” If a method is deemed to meet at least two of those criteria, the WADA says they will consider including it in their list of banned substances.

In 2006, the WADA considered banning altitude training chambers, but ultimately decided not to add it to their list of banned methods, partly in light of their inability to find a reliable way to test for the usage of those chambers.

“It doesn’t mean we approve it,” head of the WADA, Dick Pound, said at the time.

CVAC has the potential to cross even further into questionable territory as it becomes more prevalent among professional athletes.

Part of the argument for allowing altitude training chambers to be used has to do with the fact that their results can replicated in the natural world. An athlete can sleep on a mountaintop, and then train at the base of the mountain to get the same results.

But CVAC’s technology, which cycles more rapidly through altitudes, is not replicating any sort of natural condition. Its cyclical nature could not be found anywhere else in the world except in a CVAC chamber.

Ruszkowski believes that CVAC has the ability to discourage athletes from exploring more harmful performance enhancing methods, such as blood doping.

“I think that the fact that we increase the VO2 max more than the blood doping will reduce the motivation for athletes to dope,” Ruszkowski said. “We’ve also had some experience with athletes, particularly cyclists, who we suspected of doping. And when they got into the CVAC pod, they didn’t do as well. There wasn’t anything life-threatening, but they got nauseous. Whenever the body gets nauseous, it’s telling you it doesn’t like something, and it is basically saying, I don’t need these drugs.”

Difficulty of Testing.

Despite the WADA’s ongoing concerns about altitude training chambers, testing for usage of these chambers remains virtually impossible, particularly since there is no way to tell whether the increased VO2 max is as a result of training at a high altitude or as a result of sitting in an altitude training device.

And despite CVAC’s differences with traditional altitude training, there is no evidence that CVAC usage can be specifically detected in an athlete.

Even more sophisticated tests are likely incapable of detecting the usage of CVAC, including the biological passport, a test of biological markers over time used in other endurance sports.

“Based on some pretty extensive tests at three different clinics, there was no concern that we would be tripping off the biological passport,” Ruszkowski said. “There are a lot more athletes using CVAC than people know about. None of these athletes have ever been suspected of doping after they did the urine and blood tests. Before they did the urine and blood tests, their performance improved so much they were suspected, but after they did the blood tests, there was never any concern.”

A Higher Standard?

Though Novak Djokovic has violated no WADA rules, his use of CVAC has raised eyebrows, considering the WADA’s public position that the technology violates the spirit of sport. Admitting to using a technology that is frowned upon by the WADA has provided ammunition to some who question Djokovic’s sudden success.

Ruszkowski, when asked about Djokovic’s reluctance to admit to using the CVAC technology regularly, was convinced that Djokovic’s denial was more due to proprietary concerns than efforts to stave off controversy.